Objective: In this paper, we aim to provide a systematic review and meta-analysis on the prevalence rates of mental health symptoms of anxiety, depression, and insomnia among the major populations during the COVID-19 pandemic in Africa. Design: A systematic review and meta-analysis. Data sources: We search and include articles using PubMed, Embase, Web of Science, PsycINFO, and medRxiv databases between Feb 202 and Feb 6th, 2021. Eligibility criteria and data analysis: The meta-analysis targets the prevalence rates of mental health symptoms of major populations including frontline/general healthcare workers (HCWs), the general adult population, and medical students during the COVID-19 pandemic in Africa. To estimate the prevalence rates of anxiety, depression, and insomnia, we pooled data using random-effects meta-analyses. Results: In this meta-analysis, we identify and include 28 studies and 32 independent samples from 12 countries with a total of 15,072 participants in Africa. Ethiopia (7) and Egypt (6) had the largest number of studies. While many countries including, but not limited to, Algeria, Kenya, and Ghana had a high number of COVID-19 cases, as many as three quarters of African countries have no studies. The pooled prevalence of anxiety in 27 studies was 37% (95%CI: 31-43%, I2 = 99.0%) and that of depression in 24 studies was 45% (95%CI: 36-51%, I2 = 99.5%) and that of insomnia in 9 studies was 28% (95%CI: 20-41%, I2 = 99.2%). The pooled prevalence rates of anxiety, depression, and insomnia in North Africa (44%, 55%, and 31%, respectively) are higher than the rates in Sub-Saharan Africa (31%, 30%, and 24%, respectively). Our analysis indicated high heterogeneity and varying prevalence rates of mental health symptoms during the COVID-19 pandemic in Africa. Discussion: We discuss our findings that a) a scarcity of studies in several African countries with a high number of COVID-19 cases, b) high heterogeneity among the studies, c) the extent of prevalence of mental health symptoms in Africa to be high, and d) the pattern of mental health symptoms in Africa differs from elsewhere, i.e., more African adults suffer from depression rather than anxiety and insomnia during COVID 19 compared to adult population in other countries or regions. Hence, our findings carry crucial implications for healthcare organizations and future research to enable evidence-based medicine in Africa. Our findings also call for increased scholarly attention on Africa, the least studied continent with a limited amount of research on mental health symptoms under the COVID 19 pandemic. Keywords: Mental Health; Prevalence; Pandemic; General Population; Healthcare Workers; Anxiety; Depression; Insomnia Trial registration: CRD42020224458

中文翻译：

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非洲COVID-19危机下的心理健康：系统评价和荟萃分析

目的：本文旨在对非洲COVID-19大流行期间主要人群的焦虑，抑郁和失眠心理健康症状的患病率进行系统的回顾和荟萃分析。设计：系统的审查和荟萃分析。数据来源：我们在2021年2月202日至2021年2月6日之间使用PubMed，Embase，Web of Science，PsycINFO和medRxiv数据库搜索并纳入了文章。入选标准和数据分析：荟萃分析针对的是心理健康症状患病率非洲COVID-19大流行期间的主要人群，包括一线/普通医护人员（HCW），一般成年人口和医科学生。为了评估焦虑，抑郁和失眠的患病率，我们使用随机效应荟萃分析汇总了数据。结果：在这项荟萃分析中，我们确定并包括来自12个国家的28个研究和32个独立样本，非洲共有15,072名参与者。埃塞俄比亚（7）和埃及（6）的研究数量最多。尽管包括但不限于阿尔及利亚，肯尼亚和加纳在内的许多国家都有大量的COVID-19病例，但多达四分之三的非洲国家没有研究。27项研究的焦虑综合患病率为37％（95％CI：31-43％，I2 = 99.0％），抑郁症的综合患病率为45％（95％CI：36-51％，I2 = 99.5％） ）和9项研究中的失眠率为28％（95％CI：20-41％，I2 = 99.2％）。北非焦虑症，抑郁症和失眠症的合并患病率（分别为44％，55％和31％）高于撒哈拉以南非洲地区的患病率（分别为31％，30％和24％） 。我们的分析表明，在非洲COVID-19大流行期间，精神健康症状的异质性很高，并且患病率也有所不同。讨论：我们讨论了以下发现：a）在几个COVID-19病例数很多的非洲国家中缺乏研究，b）研究之间的异质性很高，c）非洲心理健康症状的普遍程度很高和d）非洲的心理健康症状模式与其他国家不同，即与其他国家或地区的成年人口相比，在COVID 19期间遭受抑郁症困扰的非洲成年人多于焦虑和失眠症。因此，我们的发现对医疗机构和未来的研究产生了至关重要的影响，从而推动了非洲的循证医学的发展。我们的发现还呼吁对非洲增加学术关注，研究最少的大陆，在COVID 19大流行下对精神健康症状的研究数量有限。关键词：心理健康；患病率 大流行病; 总人口; 医护人员; 焦虑; 沮丧; 失眠审判注册：CRD42020224458